Today's use of internet technology brings with it “cost effectiveness” for Tele-psychiatry applications. Today, with a relatively current laptop computer, a web-cam, broadband connectivity (128 kbs or faster), and a free downloadable, secure video conference application, makes this technology available literally and virtually everywhere, anywhere, and at any time. We provide individual assessment, medication management, psychotherapy services and a unique “Co-Therapy” model in the treatment of Opoid Dependence. Study patients are located throughout the states of Arizona, and Alaska. Availability of broadband connectivity is the only limiting factor to access.We have compared the effectiveness of “Home-Telepsychiatry”, to more traditional “office based” Tele-Psychiatry over 8 years with 800 Home Telepsychiatry cases, and 1200 Office based cases. There is a clear patient preference for the Home-Telepsychiatry model. Compliance is dramatically improved as is the no-show statistic dramatically decreased. Outcome data clearly favors the Home-Telepsychiatry model.Mentally ill patients favor treatment provided in “their private space”. Providers learn more about their patients when we are a “guest” in the patient's home. Access to “patient support providers”, spouses, parents etc. is easy and more valuable using Home-Telepsychiatry.